Individual provider Active NPI

Edmund Gordon Byne, MD

  • Family Medicine Physician
  • Keysville, GA
National Provider Identifier
1033186648
Registry record updated Feb 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
024786 Issued in GA
Practice address
480 Martin Luther King Rd Lot B
Keysville, GA 30816-4464
Phone
(762) 994-0902
Fax
(762) 994-0907
NPI assigned
Mar 2, 2006
Last updated
Feb 18, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 024786 GA Primary

Addresses

Primary practice location

480 Martin Luther King Rd Lot B
Keysville, GA 30816-4464

Mailing address

2467 Golden Camp Rd
Augusta, GA 30906-5515
Phone (706) 790-4440

Other practice location 1

961 E Winthrope Ave
Millen, GA 30442
Phone (478) 982-9081

Other practice location 2

301 Jones Ave
Waynesboro, GA 30830-1510
Phone (706) 554-2176

Other practice location 3

2467 Golden Camp Rd
Augusta, GA 30906-5515
Phone (706) 790-4440

Other identifiers 1

IdentifierTypeStateIssuer
145149011AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040628000992 GA Practitioner - Family PracticePractitioner - Emergency Medicine 2062498223 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Medical College of Georgia School of Medicine, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2300 Wrightsboro Rd
Augusta, GA 30904-6220
Phone (706) 790-4440

2467 Golden Camp Rd
Augusta, GA 30906-5515
Phone (706) 790-4440

301 Jones Ave
Waynesboro, GA 30830-1510
Phone (706) 790-4440

480 Martin Luther King Rd
Lot B
Keysville, GA 30816-4464
Phone (706) 790-4440

501 E Broad St
Wrens, GA 30833-1185
Phone (706) 790-4440

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Improvement Project, Inc CurrentSince Oct 1, 2015 Accepting new patients
Neighborhood Improvement Project Inc Family Medicine CurrentSince Oct 1, 2015 Accepting new patients
Neighborhood Improvement Project Inc PastSince Feb 21, 2021 Accepting new patients
Neighborhood Improvement Project, Inc Past Accepting new patients

Locations

2467 Golden Camp Rd
Augusta, GA 30906
Phone (706) 922-0682

480 Martin Luther King Rd
Lot B
Keysville, GA 30816
Phone (762) 994-0902

301 Jones Ave
Waynesboro, GA 30830
Phone (706) 437-0770

501 E Broad St
Wrens, GA 30833
Phone (706) 547-2559

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1033186648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2467 GOLDEN CAMP RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309065515",
            "telephone_number": "706-790-4440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 MARTIN LUTHER KING RD LOT B",
            "city": "KEYSVILLE",
            "state": "GA",
            "postal_code": "308164464",
            "telephone_number": "762-994-0902",
            "fax_number": "762-994-0907"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "961 E Winthrope Ave",
            "address_purpose": "LOCATION",
            "city": "Millen",
            "state": "GA",
            "postal_code": "30442",
            "country_code": "US",
            "telephone_number": "478-982-9081",
            "fax_number": "478-982-8843",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301 Jones Ave",
            "address_purpose": "LOCATION",
            "city": "Waynesboro",
            "state": "GA",
            "postal_code": "308301510",
            "country_code": "US",
            "telephone_number": "706-554-2176",
            "fax_number": "706-437-0006",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2467 Golden Camp Rd",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309065515",
            "country_code": "US",
            "telephone_number": "706-790-4440",
            "fax_number": "706-790-4393",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BYNE",
        "first_name": "EDMUND",
        "middle_name": "GORDON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-02",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "024786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145149011A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Keysville, GA

Sources for this page

Verify at the official NPI Registry.